• C H Sandoval-Jiménez, G J Méndez-Sashida, L M Cruz-Márquez-Rico, R Cárdenas-Victorica, H Guzmán-Esquivel, M Luna-Silva, and R Díaz-Valero.
• Servicio de Cirugía General, Hospital de Especialidades No. 1, León, Guanajuato, IMSS. mdsandoval@hotmail.com
• Rev Gastroenterol Mex. 2009 Oct 1;74(4):314-20.

BackgroundLaparoscopic cholecystectomy is the gold standard in the management of symptomatic gallstone disease. Postoperative abdominal and shoulder-tip pain are the main adverse side effects.AimTo determine whether the low-pressure pneumoperitoneum (7 mmHg) decreases postoperative pain in patients undergoing laparoscopic cholecystectomy compared with standard pressure pneumoperitoneum (12-15 mmHg).Material And MethodsDouble-blind clinical trial that included 68 patients divided into two groups: low-pressure and standard pressure pneumoperitoneum. Main variables assessed were abdominal pain at 6, 12 and 24 hours (by visual analogue scale), the incidence of shoulder- tip pain, time and quality of exposure of the surgical field. Variables were compared using Chi square and T-Student, considering significance at p<0.05.ResultsThe demographic characteristics of patients were similar in both groups. Abdominal pain was significantly less at 12 and 24 hours in the group with low-pressure pneumoperitoneum (p=0.02). The presence of shoulder-tip pain occurred more frequently in the group with standard- pressure pneumoperitoneum (p=0.007).ConclusionsLow-pressure pneumoperitoneum significantly reduces abdominal and shoulder tip pain. Key words: pneumoperitoneum, laparoscopic cholecystectomy, postoperative pain, shoulder pain, complications, Mexico.

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